title: Hemeoxygenase-1 mediated hypercoagulability in a patient with thyroid cancer.
abstract: Thyroid cancers can cause significant regional thrombotic morbidity and mortality. Of interest, thyroid cancer cell lines can have upregulation of the carbon monoxide-producing enzyme, hemeoxygenase-1. Carbon monoxide has been demonstrated to markedly enhance plasmatic coagulation in vitro and in vivo via enhancement of fibrinogen's substrate properties by binding to a fibrinogen-associated heme group(s). We present a patient undergoing removal of a malignant thyroid tumour who was serendipitously found to have abnormally increased carboxyhaemoglobin concentration (2.4%) and plasmatic hypercoagulability with a carbon monoxide-mediated clot strength as determined by a thrombelastographic method. This initial observation serves as a rationale to further investigate the role played by hemeoxygenase-1 upregulation in the setting of cancers associated with increased endogenous carbon monoxide production.
authors.affiliation: Department of Anesthesiology bDepartment of Surgery, The University of Arizona College of Medicine, Tucson, AZ, USA. vgnielsen@email.arizona.edu
authors.forename: Vance G
authors.initials: VG
authors.lastname: Nielsen
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Garol
authors.forename: Eric A
authors.initials: EA
authors.lastname: Zelman
authors.forename: Marlon A
authors.initials: MA
authors.lastname: Guerrero
mesh_terms: D000368:Aged; D005260:Female; D051547:Heme Oxygenase-1 / Q000378:metabolism*; D006801:Humans; D013916:Thrombelastography / Q000379:methods; D019851:Thrombophilia / Q000097:blood* / Q000201:enzymology*; D013964:Thyroid Neoplasms / Q000097:blood* / Q000201:enzymology*
chemical_list: D051547:Heme Oxygenase-1